Testicular cancer affects around 2,300 men each year in the UK, making it relatively rare. However, unlike many cancers that are more common in old age, testicular cancer affects young men, with cases being highest in men aged 30-34. It is one of the most treatable types of cancer when diagnosed early, which is why performing regular self-exams is so important. 

What is testicular cancer?

Testicular cancer occurs when cells in one or both of your testicles grow abnormally. The testicles are two oval-shaped organs that are part of the male reproductive system. They are located in a pouch called the scrotum, just under the penis. Most cases of testicular cancer start in the germ cells, which are responsible for making sperm. 

Symptoms of testicular cancer

A painless lump is the most common symptom of testicular cancer but there are other symptoms to look out for, including:

• A swollen testicle — this is usually painless but may suddenly feel painful
• An ache, pain or feeling of heaviness in your scrotum
• Pain in your lower back
• Pain in your testicle
• Tenderness in your chest and around your nipples

In most cases, these symptoms are caused by something other than cancer. It is much more likely to be an infection or cyst. However, it is still important to have any symptoms checked by your GP.

Performing a self-exam

Checking your testicles is easy to do and doesn’t take long. The best time to do it is either in the shower or just after you have a warm bath or shower. This is because your scrotum will be relaxed, making it easier to feel your testicles. You should do a self-exam once a month from puberty onwards. 

The first few times you check your testicles, you will be getting to know what feels normal for you. Everyone is different and most men have one testicle that is slightly larger than the other. It is also normal for one testicle to hang lower than the other. A normal testicle should feel smooth and quite firm but not hard. 

Hold your scrotum in your palm and use the forefingers and thumb of both hands to gently feel the testicle, rolling it and moving your fingers around so that you check the whole testicle during your examination. Check for any lumps, swellings or pain.

At the top of each testicle, you will find the epididymis, which is the tube that carries sperm through your testicles. The epididymis should feel like a coiled-up, soft tube. Harmless cysts and lumps are quite common in the epididymis. However, if you notice a lump in your epididymis, you should still see your GP to rule out cancer. 

Diagnosis and treatment

If you do find a lump or notice any changes in your testicles, the first step is to contact your GP. Your GP will examine you and if they think cancer is a possibility, they will arrange further tests. A blood test and an ultrasound scan of your testicles is usually the first stage of testing. An ultrasound scan uses a handheld device that produces sound waves to create a picture of the inside of your testicle. If cancer is found you may need to have a CT scan, which uses X-rays to capture a more detailed image of the inside of your body, to check for signs of whether the cancer has spread. 

In most cases, the cancerous testicle is removed surgically during a procedure called an orchidectomy. For some men, this is all that is needed and a prosthetic testicle can be put in for cosmetic reasons. However, for other men, a short course of chemotherapy or radiotherapy is also needed, especially if the cancer might have spread.